Organization
WISES DRUG STORE INC
Active
Other names
Wise's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR H WISE III (PRESIDENT)
(904) 727-8362
Entity
Organization
Contact information
Practice address
708 SW 4TH AVE, GAINESVILLE, FL 32601-6427
(352) 376-8286
(352) 374-3799
Mailing address
708 SW 4TH AVE, GAINESVILLE, FL 32601-6427
(352) 376-8286
(352) 375-8686
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH374
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103626200
—
FL
05
—
673317498
—
FL
Enumeration date
02/08/2007
Last updated
12/16/2022
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